The Metro-Minnesota Community Clinical Oncology Program(MMCCOP) represents a consortium of nine hospitals which, through its NCI-funded Community Hospital Oncology Program ("CHOP") and operational CCOP, has developed acommon approach to the management of cancer patients and has an established mechanism for identifying, entering and following patients on treatment and cancer prevention and control protocols. The consortium has a community-wide computerized data management system capable of prospective data collection. The community offers PPOs, HMOs and commercial healthcare programs, all of which are represented among these nine consortium hospitals. Together, the nine hospitals see an averageof 9700 new analytic cancer patients per year. The 100 core and pending new investigators, representing medical and radiation oncology, hematology, urology, gynecologic oncology, neurology, ENT, family practice, general and specialty surgeons, have worked extensively together on cancer program development and protocol development of the current program structure and operation. During the most recent NCI-funded grant year (6/03-5/04), 880 patients/participants (192.3 treatmentcredits+299.6 cancer control credits) were accrued to NCI-approved treatment and cancer prevention and control studies. The MMCCOP intends to sustain a region wide community and hospital consortium, which provides the community with the most recent advances in cancer prevention, control and treatment. This will be accomplished through further expansion of the CCOP into established outreach communities; work withhospitals, foundations, insurers and Integrated Service Networks (ISNs) to develop funding and reimbursement support for participation in clinical trials; increased involvement of primary care physicians; providing the expertise, resources, and large population base to develop, implement and evaluate clinical cancer treatment and control trials through affiliation with the NCI, CTSU, ECOG, GOG, MD Anderson, NSABP, RTOG, URCC and pilot project with the NCCTG; improve and expand the current MMCCOP data management and communication system to increase the number and level of participation of the investigators in accrual, program operations and research base activities; implement new strategies to improve access and participation of minority and underserved groups; and increase the professionaland lay community awareness of the CCOP and benefits of clinical cancer trials. Based upon past experience, the availability of cancer control and prevention trials, multiple research bases and successful cancer control implementation models, MMCCOP investigators intend to enroll 1040 (581.6 credits/413.5 new + 168.1 follow-up) patients/participants onto NCI-approved cancer treatment and control studies during the first year, with the goal of continually exceeding the NCI requirements for both types of studies. Prior MMCCOP applications were viewed by reviewers at that time as "overly optimistic",but were exceeded. The goal for the first year of this grant is again optimistic, but realisticgiventhe expertise of the group, available protocols, the established systems and strong support of the physiciansandhospitals.